Sunday, January 06, 2013

dismantled

The night has
come down quick and glassy, hard-edged with the lights in the shop windows, a huddled,
hectic quality to everything, the restless herds of SALE shoppers and finishing
office workers migrating east, west, north and south along the main
thoroughfares, buses stacked full of people, their windows steamed, taxis and
cars beeping and jostling for position. The store we’ve been called to is so
centrally located it’s difficult to find a clear space to park. Luckily, one of
the buses is just moving off leaving just enough room for Rae to squeeze the
ambulance in. One of the store managers is waiting outside to greet us,
shivering a little in his starched white shirt. He waits as we grab what bags
we need out of the truck, and then hurries inside with us behind him.

‘It’s a
twenty-eight-year-old man,’ he says, holding the door. ‘He came to the pharmacy
with a scrip for inhalers of one kind or another, but when he was waiting in
the queue he started complaining of chest pain. He’s with my colleagues in our
little consulting room. This way.’

He eases us through
the crowded store. As always it’s a shock for the shoppers to see us there.
They double take as we struggle past with all our bags. Sometimes we have to
ask twice to get round; I can only suppose we’re so crashingly out of place it effectively
makes us invisible.

Michael is
sitting on a chair in the tiny consulting booth, bent in half with both hands
crossed flat across his breast, rocking backwards and forwards making a noise
that’s a cross between a grunt and a growl. He’s such a skinny guy, my first
thought is that he might have had a spontaneous pneumothorax. Checking his chest with my steth is difficult
because he’s making so much noise, but it sounds as if there’s equal air entry.
I hesitate for a moment, but his SATS are fine – and then, to reassure me even
further, someone opens the door to pass a message to the manager, and Michael
suddenly straightens up and looks directly at them.

‘Who’s that?’ he
says, clearly and flatly. ‘What the fuck do they want?’

There’s an
uncomplicated directness to the way he says this – and certainly not the way
you’d expect someone to speak who was struggling to breathe.

The person delivers
their message and with one last, appalled glance at Michael, withdraws in a
hurry.

‘Come on,
Michael. Sit up for us. It’ll help with your breathing. And you’ve got to slow
it right down. Easy, easy. Like this, look. In through the nose, out through
the mouth – blow it out nice and slow. In, two, three – hold and out, two,
three...’

Eventually he
sits back and stares at me with a skinned expression, like a feral creature
trapped in a cage.

‘What’s the
matter with me? They said I was having a heart attack. They did this. They
wound me up.’

Michael’s partner
Julie is in the room with us. A short, dark woman whose blunt expression is only
emphasised by the metallic blue of her eyeshadow, she shifts restlessly and
picks at her teeth with her scarlet nails.

‘He’s had a lot
of stress lately,’ she says. ‘Before he ran over here he was getting himself
proper worked up. He came out of the bedroom and just dismantled himself.’

‘Dismantled himself?’

‘Yeah, you know.
Dismantled.’

‘Shut up!’ says
Michael, shivering a little and jiggling his knees up and down. ‘I’m dying here
and what are you talking about?’

‘Have you had any
drugs tonight, Michael?’ I ask him.

‘I sniffed some
stuff, yeah.’

He bobs his head
down again and I can’t quite hear what he says.

‘Sorry? Was that
heroin, did you say?’

He looks up again
and sneers.

‘Fuck off!
Heroin? Who sniffs heroin?’

‘I don’t know. I
thought..’

‘Cocaine, mate. I did some cocaine. But so what? I do it all the
time. That’s nothing new. I lived in Barbados for years. That’s some proper mad
shit there, man. You should try it.’

He laughs, like
he’s wasting his time with me.

‘Michael – we need
to get you out to the ambulance to do some checks, an ECG and the rest of it.
Heavy cocaine use can have an effect on your heart, especially if you mix it
with alcohol. But I’m sure you know all this.’

‘No, man. I’m
good. I just can’t breathe. Why’ve I got this pain in my chest? They said it
was a heart attack. What’s the matter with me, bro?’

‘He just needs to get some sleep,’ says Julie.
‘Come on, babe.’

‘Yeah. Sleep. I
gotta sleep. I can’t remember the last time I had a good sleep.’

‘Come on then.
Let’s take a slow walk out. But I want you to concentrate on keeping your
breathing nice and slow for us. Okay?’

We help him stand.
The pharmacy manager and his assistant are so relieved to be getting Michael
out of the store they do everything with super-brisk efficiency. The manager clicks
his fingers and gives directions; his colleagues scatter right and left to make
a passage for us through the crowds to the service lift. Michael is still
clutching his chest, grunting and groaning and dragging his feet. I feel sorry
for the shoppers who watch as we go. They stand appalled, clutching their
selections from the Two for One promotions in skin care, suddenly face to face
with Michael the crack head, sweating horribly, his prominent teeth glistening,
rolling his head from side to side and casting silvery-eyed stares around him. He
snarls at a woman.

JM - I like that phrase, too. Very unusual - but very apt, too. I think much of what he was experiencing was anxiety-related.

MD - Definitely! When he was asking us what was wrong with him, in a kind of panicked, 'what the hell's happening?' kind of way, it was odd that he didn't think years of cocaine and alcohol may have been a contributory factor!